title: Use of heparin alone in treating pulmonary emboli found in association with in-transit right-heart thrombi in a nonagenarian.
abstract: In patients who present with pulmonary embolism, right-heart thrombus is a rare condition that is associated with increased mortality rates, compared with pulmonary embolism alone. Thrombolytic therapy has been associated with a survival benefit in previous studies of pulmonary embolism arising from right-heart thrombus. However, older patients have been excluded from such studies because thrombolysis places them at excessively high risk of bleeding. We present a case, in a 92-year-old woman, of pulmonary embolism arising from right-heart thrombi that we successfully treated with heparin.
authors.affiliation: Departments of Internal Medicine (Drs. Mahatanan and Temtanakitpaisan), Pulmonary and Critical Care (Dr. Rishikof), and Cardiology (Dr. Young), MetroWest Medical Center, Framingham, Massachusetts 01702.
authors.forename: Yutthapong
authors.initials: Y
authors.lastname: Temtanakitpaisan
authors.forename: Rattanaporn
authors.initials: R
authors.lastname: Mahatanan
authors.forename: David C
authors.initials: DC
authors.lastname: Rishikof
authors.forename: David Z
authors.initials: DZ
authors.lastname: Young
mesh_terms: D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Aged, 80 and over; anticoagulant drugs; coronary thrombosis/therapy; female; heparin; pulmonary embolism/etiology/ultrasonography; respiratory insufficiency/etiology; thrombolytic therapy